Common foot and leg problems

Common normal variants (or normal differences within the population) in children’s development, listed below. Sometimes they grow out of these and sometimes they remain a characteristic for the individual.

Intoeing (Pigeon Toes)
Intoeing, sometimes called pigeon toe, is where the feet point inwards when a child walks rather than straight ahead. It’s a normal variation in walking patterns and often seen in toddlers. Causes include inward twist of the thigh bone (femoral anteversion), an inward twist of the shin bone (internal tibial torsion), or a curved foot shape (metatarsus adductus). In most children it improves naturally as they grow, and special shoes or exercises do not speed this up.

Flat Feet (Fallen Arches)
Flat feet occur when the inner arch of the foot lies flat against the ground. Many children have flexible flat feet when they are young, and the arch often develops between the ages of 3 and 10. Flat feet usually do not cause pain or problems and don’t need treatment. If flat feet are painful, stiff, weak, or lead to frequent injuries, a GP or specialist (such as a podiatrist) may offer advice on footwear, insoles, stretches, or exercises. Surgery is rare.

Bow Legs (Genu Varum)
Bow legs describe a leg shape where there is a noticeable gap between the knees when the feet and ankles are together. This is a common part of normal growth in infants and young toddlers, and the legs usually straighten naturally as the child grows older. Most children outgrow bow legs by the age of three. Healthcare advice may be sought if bowing is severe, not improving, only affects one leg, or is accompanied by pain.

Knock Knees (Genu Valgum)
Knock knees are when the knees touch but the ankles are apart when standing. This alignment is common between ages 3 and 5 and typically corrects naturally by age 8 to 10 as the child grows. Most children with knock knees don’t need treatment. If knock knees are painful, worsen with age, or are present in unusual patterns, a specialist assessment may be recommended.

General Leg and Foot Development Variations
Many walking and leg alignment variations are normal in childhood, including intoeing, bow legs, knock knees, tipped feet, and flat arches. These usually reflect natural changes in bone growth and muscle strength, and most resolve without intervention as children develop. Healthcare advice is appropriate when a condition causes pain, affects walking ability, is severe, or does not improve with time.